Individual
FREDERMAN CONCEPCION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5140 N CALIFORNIA AVE STE 780, CHICAGO, IL 60625-7066
(773) 989-3957
(773) 989-3971
Mailing address
2740 W FOSTER AVE, STE 310, CHICAGO, IL 60625-3547
(773) 878-8200
(773) 293-4197
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036114474
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114474
—
IL
01
—
406120090
PTAN
—
Enumeration date
05/08/2009
Last updated
04/12/2021
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